A few months ago I noticed several floaters in both eyes that were not there before. I knew what they were because I have had one appear in my peripheral vision nearly a decade ago. These new floaters are very irritating because they are in my direct-line of sight.
There are two main methods to remove floaters in the eye:

2) YAG Laser to remove the floaters
a. New procedure, limited doctor availability.
b. From what I’ve read it can cause increased eye pressure but the doctors note that if a patient has that, it should go away eventually.
c. Very low complication rate, although it is not zero.

My questions to those here:
1) Has anyone had either procedure?
2) How was your outcome?
3) For those living with eye floaters directly in your field of vision, how do you cope with it?
4) Has anyone had any floaters that were in their line of sight that went away eventually?
5) Is there any method to “shift” irritating floaters to another part of the eye without surgery?

I have had floaters in both eyes due to vitreous degeneration. The floaters wre large and numerous. They were in my central visual fields of both eyes. I had to do something. You are right - there are two options: vitrectomy or try laser removal.

I began with laser removal. I had two different sessions of laser treatments in 2012. Neither session resulted in the removal of the floaters. The laser broke up the large floaters into a swarm of smaller floaters. I was no better off than when I began.

Recently I had a vitrectomy in my right eye. Two ports were used, 25 ga each, and the procedure took less than 15 minutes. I was patched for 1 day and then began eye drops for 2 weeks. My vision initially was quite blurry but over the course of 6-7 days returned to normal. The vitrectomy resulted in 99.95% floater removal. I have 3-5 small residual spots now in that right eye. I intend to have the left eye done too.

My Eye surgeon told me that I will certainly get a cataract - 100% chance. I may need cataract surgery within a year he said.

I had no complications with the vitrectomy.

According to my research, only three practitioners do laser removal of floaters in USA. Perhaps this should raise your eyebrows and wonder why.

If I were to advise someone, I would caution that person to carefully consider both options (and granted, the floaters would have to be thoroughly bothersome to the point that they disrupt life). I would not attempt laser removal if I had many floaters. My opinion is that the laser cannot remove all the debris if there are many to deal with. If there is a single bothersome floater, I think that has a much better chance of success.

If I had it to do all over again, I would not have done the laser surgeries. They did not help, and they increased my eye pressure significantly, and the pressure did not return to normal. For me laser removal was a complete failure.

To start, I would like to commend you for responding in such great depth and detail, this is a very thorough and helpful analysis!

Quote:

Originally Posted by konedog4

I have had floaters in both eyes due to vitreous degeneration. The floaters wre large and numerous. They were in my central visual fields of both eyes. I had to do something. You are right - there are two options: vitrectomy or try laser removal.

That is awful, was there a single event that triggered this or did you always have them?

Quote:

Originally Posted by konedog4

I began with laser removal. I had two different sessions of laser treatments in 2012. Neither session resulted in the removal of the floaters. The laser broke up the large floaters into a swarm of smaller floaters. I was no better off than when I began.

That is what I was afraid of as well, did you mention that to the practitioner? If so, what was their response? According to their website literature, they state that the floater is vaporized, which obviously is not the truth.

Quote:

Originally Posted by konedog4

Recently I had a vitrectomy in my right eye. Two ports were used, 25 ga each, and the procedure took less than 15 minutes. I was patched for 1 day and then began eye drops for 2 weeks. My vision initially was quite blurry but over the course of 6-7 days returned to normal. The vitrectomy resulted in 99.95% floater removal. I have 3-5 small residual spots now in that right eye. I intend to have the left eye done too.

Can you describe the small residual spots, are they noticeable if you are not looking for them? What caused these residual spots, did the ophthalmologist mention?

Quote:

Originally Posted by konedog4

My Eye surgeon told me that I will certainly get a cataract - 100% chance. I may need cataract surgery within a year he said.

I assume this is still worth it if you have a lot of annoying floaters..?

Quote:

Originally Posted by konedog4

I had no complications with the vitrectomy.

That is great news!

Quote:

Originally Posted by konedog4

According to my research, only three practitioners do laser removal of floaters in USA. Perhaps this should raise your eyebrows and wonder why.

Yes... indeed!

Quote:

Originally Posted by konedog4

If I were to advise someone, I would caution that person to carefully consider both options (and granted, the floaters would have to be thoroughly bothersome to the point that they disrupt life). I would not attempt laser removal if I had many floaters. My opinion is that the laser cannot remove all the debris if there are many to deal with. If there is a single bothersome floater, I think that has a much better chance of success.

I see, but I have a question regarding your comment, below.

Quote:

Originally Posted by konedog4

If I had it to do all over again, I would not have done the laser surgeries. They did not help, and they increased my eye pressure significantly, and the pressure did not return to normal. For me laser removal was a complete failure.

You mentioned the laser treatment increased your eye pressure, did this remain after the vitrectomy? Is the pressure equal in both eyes? Did you notice the pressure after the first treatment or second treatment? Has it subsided at all from the laser treatment or has it remained the same?

As to what triggered my bilateral floaters, no one can say. I was near-sighted all my life and had lasik surgery about 10 years ago. Both are factors for floaters as I read the literature. My floaters started in 2009 in my right eye and within a year, my left eye had floaters. I put up with them until others appeared in 2011 and 2012. I had so many floaters that I could no longer see clearly. I had to do something about them.

I had my first session of floater removal done and the large floaters were broken up into a lot of smaller floaters. This was better than having the larger floaters, but still very annoying, as all the floaters swirled about as though I were inside a Christmas globe with snow swirling, except these "snowflakes" were various shaped gray masses, from semi-large to very small. The doctor asked if I could see any more floaters after the procedure, and I honestly answered no, but since I was dialated, I could not focus on any floaters. When the dilation wore off, the floaters then became visible. I was told by the doctor that as long as bothersome floaters remained, we should continue with lasering. Thus, I also went back a second time, hoping that the remnants of the first lasering could be cleaned up, but it was not to be. After I left the second time, I had not gotten any better, in fact, I could argue I got worse, as there were even more little floaters to deal with.

As far as pressure issues. My eyes had low-normal pressure when I began the laser therapy. When I went back the second time (6 months later), my pressure had climbed by 3 points in both eyes. After that second therapy session, the pressure began slowly rising in both eyes until both were at 23. Having the vitrectomy in the right eye resulted in a pressure reading of 10. I still have a reading of 23 in my left eye. So, I must conclude that the lasering caused the increase in pressure.

I wasted a year trying to solve my floaters with lasers. Now, retrospectively, I wish I had gone right with the vitrectomy.

Finally, in regards to the vitrectomy, I initially had several very small floaters, like a gnat size, that bothered me. For the past three days i have not noticed them. That is not to say that they are gone, but I don't see them and the right eye is SO much clearer than the left. I see my eye doctor tomorrow and will ask when I can have the left eye done, as the left eye floaters are even more noticeable now that my right eye is clear.

Let me once again state this very clearly: Vitrectomy is a surgical option that is really only for those people whose floaters are exceptionally bad and bother them all day long. The only relief I got from the floaters is when I closed my eyes to sleep. Having them open all day long almost always gave me a headache by the end of the day. So if a person suffers from these kind of floaters, then a vitrectomy is the only chance that person has to regain clear vision. But please remember, it is not fraught with potential complications - these being retinal detachment and infection. A vitrectomy is a last-resort measure. And the person must also be aware that future cataract surgery is virtually guaranteed.

I believe there may be a place for laser floater removal, but only for those who have a single solitary floater that can be broken up into significantly smaller pieces to afford better and clearer vision. Having many floaters, and larger floaters is probably contraindicated for laser treatment. This is my personal opinion based on what happened to me.

As to whether laser surgery vaporizes floaters seems to be up to debate. I went into laser therapy thinking that lasers vaporised floaters, and that is why I pursued it for two sessions. But for me it did not happen; lasering merely made the large floaters into uncountable smaller ones. All of the opthamologists I have consulted with (besides the laser doctors) do not believe that lasering vaporizes floaters. I now would caution anyone thinking about laser floater removal to only do so for one 3-day session. If it does not work in that time period, it probably will not get any better. In addition, the floater(s) should be singular and not many (as mine were).